29 Fish Tapeworm

Humans defecates into water.

Eggs,proglotids.

Eggs hatch and get into water flea.

These go into trout, talapia, carp (freshwater fish). Creating cysts in fish muscle.

Fish eaten and go into cat/dog/human

Zoonosis. Fish-Oral Transmission

Worms can live several years

Need people eating freshwater fish, where poor sanitation, poor inspection of fish.

29.1 Presentation

Usually people are fine.

Sometimes passage by rectum

But you can get megaloblastic anaemia as fish tapeworm loves vitamin B-12. Same mechanism can cause early-onset dementia.

29.2 Diagnosis

  • Eaten Fish?
  • Passed a tapeworm?
  • Check stool for eggs (bigger than most other eggs)
  • Colonoscopy
  • Eosinophilia is not normal (as they shouldn’t get one)

29.3 Treatment

  • Praziquantel
  • Replace B12
  • Break Transmission Cycle